Objective To explore the influence of radiation therapy on CD3 +,CD4 +,CD8 +,CD4 +/CD8 + in patients with lung cancer.Methods The clinical data of 90 patients with lung cancer undergoing radiotherapy in Lishui Central Hospital were studied.The radiation dose and target volume were recorded.The CD3 +,CD4 +,CD8 + and CD4 +/CD8 + in peripheral blood were determined by flow cytometry.Results After radiotherapy,the CD3 + [(61.48 ± 1.86) ％] was no significant difference with that before radiotherapy [(61.12 ± 1.83) ％],P ＞ 0.05,the levels of CD4 + and CD4 +/CD8 + [(26.85 ± 1.28) ％,0.71 + 0.06] were significantly lower than those before the treatment [(36.24 +± 1.25) ％,1.22 + 0.08] (P ＜ 0.05),the CD8 + content [(37.92 ± 1.66) ％] was higher than that before the treatmnent [(29.79 ± 1.12) ％],P ＜ 0.05.After radiotherapy,CD3 + abnormality ratio (32.2％) was no significant difference with that before radiotherapy (34.4％),P ＞ 0.05,the percentage of abnormal CD4 +,CD4 +/CD8 + (85.6％,67.8％) was lower than that before the treatment (53.3 ％,31.1％),P ＜ 0.05.The CD3 +,CD4 +,CD8 +,CD4 +/CD8 + radiation therapy dose ≥ 60 Gy patients [(63.43 ± 1.85) ％,(27.23 ± 1.28) ％,(37.53 ± 1.17) ％,0.72 ± 0.07] was not statistically significant with radiation dose ＜ 60 Gy [(61.12 ± 1.77)％,(26.77 ± 1.31)％,(38.08 ± 1.36)％ and 0.69 ± 0.05],P ＞0.05.There was no significant difference of CD3 between target volume ＞ 440 cm3 [(61.88 ± 2.23) ％] and target volume≤440 cm3 [(59.99 ±2.17) ％],P ＞0.05,the CD4 +,CD4 +/CD8 + [(24.37 ± 1.68) ％,0.68 ±0.06] were significantly lower than those with target volume ≤440 cm3,the CD8 content[(41.46 ± 2.59)％] was higher than that of target volume ≤440 cm3 [(34.27 ± 2.13) ％],P ＜ 0.05.Conclusion The immune of lung cancer patients before radiotherapy is dysfunction.The immune function after radiation therapy decreases further.The immune function of patients with lung cancer is related to radiation target volume,the larger the target volume,the lower the immune function.

目的 探讨厄洛替尼联合全脑放疗(whole brain radiotherapy,WBRT)治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移患者的临床效果及预后影响.方法 选取2013年9月～2015年5月丽水市中心医院收治的NSCLC脑转移患者100例,根据患者是否使用厄洛替尼分为对照组54例和观察组46例,2组均给予WBRT治疗,对比2组患者的近期效果、远期预后及不良反应发生率.结果 观察组的缓解率52.17％显著高于对照组27.78％,观察组总有效率91.30％显著高于对照组72.22％,差异均具有统计学意义(P＜0.05);观察组的1年生存率52.17％(24/46)显著高于对照组29.63％ (16/54),观察组中位生存时间9.0个月显著高于对照组6.0个月,差异均具有统计学意义(P＜0.05);2组治疗过程中不良反应发生率差异均无统计学意义.结论 厄洛替尼联合WBRT治疗NSCLC脑转移患者能够提高近期疗效及远期预后的效果.

目的:观察尼妥珠单抗联合TP方案治疗晚期鼻咽癌的近期疗效及不良反应。方法:46例晚期鼻咽癌患者,分为治疗组和对照组。治疗组(n=23)采用尼妥珠单抗联合TP方案治疗:尼妥珠单抗200mg,化疗前2h静脉滴注,d1;紫杉醇针135mg/m2,静脉滴注,d1,顺铂针25mg/m2,静脉滴注,d1～3,21d为1个周期,连用4个周期。对照组(n=23)仅使用TP方案治疗,用法同治疗组。结果:46例患者均可进行疗效评价,治疗组CR43.5%,PR39.1%,RR82.6%。对照组CR8.7%,PR13.0%,RR21.7%。两组CR、PR、RR比较差异均有统计学意义(P<0.05)。治疗组和对照组主要的毒副反应比较差异无统计学意义(P>0.05)。结论:尼妥珠单抗联合TP方案能进一步提高晚期鼻咽癌患者的治疗效果,且未增加毒副反应,值得进一步研究。

目的评价晚期鼻咽癌(NPC)患者应用多希他赛与顺铂联合化疗的临床疗效及安全性。方法 2007年4月至2009年2月采用多希他赛联合顺铂治疗晚期鼻咽癌48例。中位化疗周期数3周期(2周期~5周期)。多希他赛(Docetaxel)75mg/m2,第一天静脉滴注,顺铂(DDP)80mg/m2,分4天静滴,21d为1周期。结果可评价疗效48例,CR13例(27.1%),PR25例(52.1%),NC6例(12.5%),PD4例(8.3%),总有效率(CR+PR)79.1%。中位缓解期(DFS)为6.5(2~12)个月,中位肿瘤进展时间(TTP)7.6(2~14)个月。主要毒性为骨髓抑制和胃肠道反应,Ⅲ度~Ⅳ度白细胞减少发生率为18.7%,无严重并发症发生。结论多希他赛联台顺铂治疗晚期鼻咽癌有较好的疗效,且不良反应可以耐受。

目的:评价鸦胆子油乳注射液联合放疗治疗食管癌的有效性及安全性。方法:将56例经病理实验证实为食管癌患者,随机分为综合组及单放组,单放组予以体外三野照射,每次2Gy,每周5次,DT60～70Gy/6～7周;综合组照射方式和剂量与单放组相同,在放疗开始即给予鸦胆子油乳注射液30ml加入生理盐水250ml中静脉点滴,每日1次,21天为一个疗程,连用2个疗程。结果:综合组总有效率(CR+PR)75%,单放组有效率为39.3%,综合组放疗毒副反应发生率下降,KPS评分增加。结论:鸦胆子油乳注射液联合放疗治疗食管癌能提高疗效,改善患者生存质量,降低放疗毒副反应。